Obs breech and unstable lie

Question 1

What are the options available to a breech presenting babty

Answer 1

if baby breech by 36-37 it can -
ECV (best one), ELCS, vaginal breech

if footling breech - ELCS

Question 2

What are the Side effects of ECV

Answer 2

ECV-give muscle relaxants (IM salbutamol) and analagesia, then slowly rotate the baby in the womb - with continuous CTG
In labour ward

50% sucess rate- so can need to try again/stop there

0. 5% of baby distress and emergency Csec
1. 1% risk of cord compression

Question 3

How should a vaginal breech be delivered

Answer 3

no IOL, In hospital, continuous CTG
only for multiparous SVD

Hands off aproach - should slide out
can help with pinnards - poke in popliteal fossa to bend knees
If see winging of scapula (stuck) - Lovesets - rotate baby and pull arm down

if head stuck still =mauricea smellie veit maneuvrre- rest baby on arm and pull down

Question 4

Contraindications of ECV

Answer 4

PPROM, placental abruption, abnormal doppler, severe PET, vaginal bleed

Question 5

What are the options for untable lie

Answer 5

ECV, and ELCS